MEDICARE: DR. YONGQIAN HUANG DDS, MSD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DE00010011	WA
2	1223G0001X	General Practice Dentistry	DE00010011	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4102HU	OTHER	WA	REGENCE BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0174705	OTHER	WA	STATE LABOR & INDUSTRIES

General Provider Information

NPI Number	:	1083790588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YONGQIAN HUANG DDS, MSD

Provider Business Mailing Address
First Line	:	PO BOX 34703
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-1703
Country	:	US
Telephone Number	:	206-764-0112
Fax Number	:	206-764-0489

Provider Business Practice Location Address
First Line	:	409 CUSTER WAY SE
Second Line	:	SUITE C
City	:	TUMWATER
State	:	WA
Zip	:	98501-3350
Country	:	US
Telephone Number	:	360-570-8016
Fax Number	:	360-570-8275

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	03/30/2026

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